Learning her role in a pandemic, N.W.T. health minister defers to others' expertise

Starting a new job is hard.

Starting a new job overseeing health services in 33 diverse, widely distributed and remote communities amid an unprecedented global pandemic is something else entirely.

That's the situation the Northwest Territories Health Minister Diane Thom is in. Sworn in just over six months ago, Thom took on the territorial government's largest portfolio with virtually no prior experience.

"I came in here as first of all a new MLA, a new minister, and then this pandemic hits me," she told CBC in an interview. "It was quite a head shake."

Practically overnight, Thom said, she was working "almost a 20 hour day," fielding daily calls with the territory's health experts, briefing cabinet, and going toe-to-toe with provincial and federal politicians.

That's not all. As minister of health, Thom is also responsible for extending the territory's prolonged public health emergency, which has kept borders closed, creating a grim outlook for the territory's tourism industry and forcing some former residents to hunker down in southern cities.

To date, Thom's public response to this challenge has been largely to defer to others. Political questions are answered by Premier Caroline Cochrane — her "number one go-to." On matters of health, the expertise of Dr. Kami Kandola, the chief public health officer, leads the way.

"Dr. Kandola's been the front line of all of this," Thom said. "She's our expertise here … I'm far from being a doctor."

Limited scrutiny

Putting health experts in charge of a pandemic response is hardly a controversial position. But as the territory's emergency stretches on, the indirect costs of the pandemic are likely to increase.

"The risk for our extended closure of our economies … is estimated to be greater than the risk of the deaths from the virus itself," said Colleen Davison, a social epidemiologist at Queen's University's School of Public Health. "This could have a very, very deep and long-term effect."

Closed borders and stay-at-home orders have had devastating economic consequences for many of the territory's residents, and experts warn of the serious impacts extended isolation can have on psychological health.

Police have already sounded the alarm about increased risk of domestic abuse and child exploitation in northern households during the pandemic.

"I'm sad that it's happening as a result of this order," Thom said. "I hope it's not, but I want to tell them to continue to report it to the RCMP, continue to reach out to our child and family services."

Thom oversees the department that will have to lead the response to these secondary impacts in the weeks and months to come.  But the departmental track record she inherited has been, in ordinary times, far from perfect.

I will continue to sign the order until we have a solution.- Diane Thom, health minister

External audits have repeatedly sounded the alarm about the territory's inadequate supervision of children in care, who now face elevated risk from isolation. The territory's mental health supports have long been decried as insufficient, and the N.W.T. still lacks a dedicated addictions treatment facility.

"I encourage people, if they're struggling with this, that they continue to use the resources that we have," she said. "We track the number of people that are utilizing our help line, we track the number of people that are accessing our … institutions."

"That helps guide us."

'No political influence'

Thom wasn't clear on whether Dr. Kandola, whose recommendation extends isolation orders put in place last month, considered secondary impacts in making her recommendations, or whether she is more narrowly focused on combating the spread of COVID-19.

Thom said she gets a "heads up" of Kandola's thinking before new orders are issued, but does not scrutinize her decision making.

"Basically her role is to have no political influence," she said. "She's putting measures into place for primary safety of the residents of the Northwest Territories."

"I think until it's safe to do so … Dr. Kandola will continue to take the reins on getting us through this. Myself, as minister, I'm there to support her."

Thom acknowledged that "there will be a point where politics will take over." But she suggested this may not be until the danger from COVID-19 passes completely.

"I will continue to sign the order until we have a solution," Thom said.

"When it's safe to do so, I think that's the point where we need to start to look at what the new normal will look like," she said. 

"I'm continuing to stand beside her and support her. And I think … for now, people appreciate that."